Iatrogenic post-intubation tracheal rupture treated conservatively without intubation: a case report.
BACKGROUND
Tracheal rupture is a rare but life-threatening complication that most commonly occurrs after blunt trauma to the chest, but which may also complicate tracheal intubation. We report a case of post-intubation tracheal rupture after cataract surgery under general anesthesia treated conservatively.


METHODS
Four hours after extubation, a 67 year-old woman developed subcutaneous emphysema of the facial, bilateral laterocervical and upper anterior chest. Tracheobronchial fiberendoscopy showed a posterior tracheal transmural rupture 4 cm long located 2.5 cm above the carina that opened in inspiration. The location of the lesion and features of the patient favoured conservative treatment with antibiotic cover. The patient made a full and uncomplicated recovery and was discharged fourteen days after the original injury.


CONCLUSIONS
Two therapeutic strategies are currently employed for post-intubation tracheal rupture: a non-surgical strategy for small injuries and a surgical strategy for larger injuries. This case report presented the non-surgical therapeutic strategy of a large tracheal injury.
Prunet
Bertrand
B
Department of Anaesthesia and Intensive Care, Military Teaching Hospital Sainte Anne 83000 Toulon, France. bertrand.prunet@orange.fr.
Lacroix
Guillaume
G
Asencio
Yves
Y
Cathelinaud
Olivier
O
Avaro
Jean-Philippe
JP
Goutorbe
Philippe
P